The Kentucky Public Health Leadership Institute (KPHLI) is a year-long development program for practitioners in the field of Public Health. Scholars who complete KPHLI are awarded a Certificate in Public Health Leadership from the University of Kentucky College of Public Health. KPHLI is one of 35 leadership institutes located throughout the United States. Graduation from the Institute requires completion of a Change Master Team Project that addresses a public health issue or problem.

The Change Master Projects from the 2012-2013 Cohort are compiled into the following combined report: KPHLI Change Master Projects 2013. Individual reports and deliverables from each Change Master Project team are listed below.

Dementia presents a looming problem for prisons responsible for a rapidly growing population of older people, yet to date it remains largely overlooked. With an increasingly aging incarcerated population several offenders have been diagnosed with cognitive disorders such as dementia.

Currently there are no policies or trainings that inform and educate correctional officers on the disease, on how to handle offenders with this disease, and how to maintain and manage the temperament of these offenders. Equipping correctional officers with this information would not only reduce the likelihood of an altercation and increase the safety of the officer, but it would also provide a stable environment for the offender.

‘The sad thing is that there are many inmates with mild dementia who go unnoticed in the prison system. They develop coping mechanisms which provide the correct answers to people exposed to them for a short time. It usually isn’t until they can no longer cope that we realize the problem exists. The prison systems are just too large to devote the time necessary to diagnose early dementia effectively’ – Corrections Health Care Administrator, SCI Waymart, 20121

The purpose of this project is to serve as a catalyst fulfilling the need for more information and training for correctional officers working with offenders with dementia. The training ‘Correctional Staff Training: Proper Care of Offenders with Dementia’ has been developed to expand knowledge and enhance skills of correctional staff assigned to work with offenders diagnosed with dementia. The goal of the training is to equip staff with skills needed to not only effectively communicate with offenders within this population, but to also decrease challenging behaviors; and to effectively interact with offenders diagnosed with dementia.

Local Boards of Health in Kentucky vary to some degree from board to board. Some local boards of health govern a single county and others govern an entire district. One factor of variability is the degree of functionality of the board. Many local board members understand the basics of what is required to serve on the board and some even go to great lengths to be more involved in the local public health system.

Since the past year, public health accreditation is being sought by many local health departments in Kentucky. Many of the facets of accreditation involve the local board of health as it functions as the governing entity of the organization. Therefore, it is vital for local boards of health to be up to date on their responsibilities as board members and to better understand what public health accreditation is and what it involves.

The Charlie’s Angels team decided to approach the issue of varying levels of local boards of health with our project. Our initial thought was to provide information to the local boards of health specifically related to accreditation and quality improvement. Throughout the project period, our project transformed into something more generalized, but still included aspects of accreditation and quality improvement.

If local boards of health are provided with the resources and opportunities to gain more knowledge about their responsibility in the accreditation process, they have a greater potential of becoming a high-functioning board of health.

Research suggests that those with serious mental illness (SMI) die of the same causes as the general population: chronic diseases from lifestyle factors, such as tobacco use, poor nutrition, and a lack of physical activity. However, the SMI are disproportionately impacted by these lifestyle factors and the morbidity associated with them. Accessing adequate physical health care may be difficult when resources for both the SMI individual as well as the health care system are limited. As the SMI population is underserved, there is a dearth of data on this population in Kentucky and the United States. However, there is ample research to state that integrated physical and mental health care is the best modality to provide comprehensive and sufficient care for those with SMI and the general population. This issue deserves due diligence and the attention of policy makers. Those with mental illness have the right to the same physical health outcomes as the general population.

The Quit Team set out to work towards a Tobacco Cessation project that focused on the 18-34 year old demographic smoking rate in Kentucky. Unfortunately, this target group has a rate that continues to remain higher than the total adult smoking rate. The use of systems thinking throughout the project allowed the team to develop a behavior over time graph, a causal loop diagram, and use the influences of the 10 Essential Public Health Services to address the problem. The Quit Team administered surveys during health department services to collect data on the smoking behaviors and experiences with using cessation methods by the target group. This also gave an opportunity to enable smokers to connect with locally offered cessation programs. The work completed during the project will allow for further development or recommendations about how to increase cessation program use in the 18-34 year old demographic group.

End Obesity Now (EON) was formed to address obesity in Kentucky. Originally, our focus was on the growing epidemic of childhood obesity, but through our group and individual learning, we chose to address obesity at the family level for a greater impact. Our aim is to empower families with a toolkit in order to improve decisions about nutritious eating, substitutes, helpful tips, local recipe ideas, as well as family, school, and legislative policy suggestions. The purpose of the toolkit will be to give Kentucky parents resources to help their family be healthier, and hopefully, in the process encourage parents to be advocates for health in their community.